Early Outcomes of Endoscopic Contralateral Foraminal and Lateral Recess Decompression by way of an Interlaminar Strategy in Sufferers with Unilateral Radiculopathy from Unilateral Foraminal Stenosis.
World Neurosurg. 2017 Dec;108:763-773
Authors: Kim HS, Patel R, Paudel B, Jang JS, Jang IT, Oh SH, Park JE, Lee S
OBJECTIVE: Percutaneous endoscopic contralateral interlaminar lumbar foraminotomy (PECILF) for lumbar degenerative spinal stenosis is a longtime process. Higher preservation of contralateral aspect joint in contrast with that of the method facet has been proven with uniportal bilateral decompression. The goal of this retrospective case collection was to investigate the early medical and radiologic outcomes of stand-alone contralateral foraminotomy and lateral recess decompression utilizing PECILF.
METHODS: Twenty-six consecutive sufferers with unilateral decrease limb radiculopathy underwent contralateral foraminotomy and lateral recess decompression utilizing PECILF. Their medical outcomes had been evaluated with visible analog scale leg ache rating, Oswestry Incapacity Index, and the MacNab standards. Completeness of decompression was documented with a postoperative magnetic resonance imaging.
RESULTS: Imply age for the research group was 62.9 ± 9.2 years and the male/feminine ratio was four:9. A complete of 30 ranges had been decompressed, with 18 sufferers (60%) present process decompression at L4-L5, 9 at L5-S1 (30%), 2 at L3-L4 (6.7%), and 1 at L2-L3 (three.three%). Imply estimated blood loss was 27 ± 15 mL per degree. Imply operative length was 48 ± 12 minutes/degree. Visible analog scale leg rating improved from 7.7 ± 1 to 1.eight ± zero.eight (P < zero.0001). Oswestry Incapacity Index improved from 64.four ± 5.eight to 21 ± four.5 (P < zero.0001). Imply follow-up of the research was 13.7 ± 2.7 months. In accordance with the MacNab standards, 10 sufferers (38.5%) had good outcomes, 14 sufferers (53.eight%) had wonderful outcomes, and a pair of sufferers (7.7%) had honest outcomes. One affected person required revision surgical procedure.
CONCLUSIONS: Aspect-preserving contralateral foraminotomy and lateral recess decompression with PECILF is efficient for remedy of lateral recess and foraminal stenosis. Thorough decompression with acceptable early medical outcomes and minimal perioperative morbidity could be obtained with the contralateral endoscopic method.
PMID: 28919229 [PubMed – indexed for MEDLINE]